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Infant feeding problems and cows’ milk allergy: resources for doctors

“We need access to the best tools and resources. People normally blame national service cuts, but it’s not about that. We need to look at partners and resources that are helping our patients, and who provide a huge knowledge base for us to utilise. And importantly a knowledge base wider than what we have access to.” Dr Josh, GP from Islington, London.

BREAST milk has been the inspiration for Nutricia’s research for over 40 years.

Our dedicated team of around 250 specialist scientists work directly with hospitals, laboratories and universities worldwide to ensure we remain leaders in this critical field. From the incredibly complex composition of breast milk and its functional benefits, to understanding how the diet of a breastfeeding mother influences her own health, we are striving to better understand the impact of breastfeeding on mum and baby during the all-important first 1,000 days.

To help healthcare professionals (HCPs) support mums, Nutricia Early Life Nutrition has created a series of free resources to help their patients better understand and cope with challenging periods in infant nutrition.

In addition to the resources outlined below, we have developed a range of free printed materials for healthcare professionals to use with their patients. These are completely free and can be ordered here.

Colic

It can be a serious source of stress and anxiety for Mums, in particular, and understanding around Colic is difficult to define. The cause of it is still unclear, however, our free resources and guides are there to help healthcare professionals when trying to alleviate this stress for parents.

1. Recognising and managing colic.

The sudden onset of prolonged crying can be frightening and unsettling for parents, and by the time they seek professional advice, some may feel relatively helpless. This article reviews the latest information and research into the condition to help healthcare professionals make informed and effective recommendations to help mums.

2. Evidence-based treatment for dietary management of colic.

While medical treatments for colic are generally only recommended if parents feel unable to cope, experts recognise the role that specialist milks may have in the dietary management of this common and distressing issue in formula-fed infants. This resource gives healthcare professionals advice and guidance for the diagnosis and management of colic in primary care.

3. Strategies for coping with colic.

A “colicky” and unsettled baby, who cries a lot and seemingly can’t be comforted, can deplete the energy reserves of any new parent. In this easily digestible resource Alison Wall draws upon her experience as a health visitor to suggest various ways to cope with and alleviate the stress.

Constipation

Constipation is very common and effects on average 15% of infants under one, but the cause is not always clear and it can be a source of extreme worry and stress for parents¹.

It is why Nutricia ELN has developed a series of guides, in the form of these downloadable PDFs and bite-sized articles, to help healthcare professionals support mums during the first 1,000 days:

1. A topic in 10 questions: how to manage infant constipation.

Constipation is the most common cause of abdominal pain in infants seen by healthcare professionals². Tess Mobberley, a Paediatric Matron at Stafford Hospital, offers advice on managing this distressing condition.

2. Constipation — why early diagnosis is vital

Health visitors play a key supportive role to the families of infants and toddlers experiencing constipation, says expert Dr Jenny Gordon. Offered in tandem with an effective treatment plan, this lessens distress and discomfort and helps to ensure that it does not develop into a chronic condition.

3. Constipation in infancy

Professor David Candy, Consultant Paediatric Gastroenterologist, offers recommendations on how to treat constipation in infancy.

Reflux & Regurgitation

Reflux and regurgitation are very normal symptoms for any child under six months, and occur several times a day in many healthy infants. Managing these symptoms can be challenging for parents, and healthcare professionals can play a crucial role by reassuring them and providing practical advice.

In a series of case studies, expert opinions and advice articles, we gather the latest guidelines and key information to support healthcare professionals, and help them make the correct diagnosis and help them reduce concern in parents.

1. aSTAR: an evidence-based approach to the management of infant regurgitation.

2. NICE stepwise recommendations on infant regurgitation.

3. NICE offer advice on gastro-oesophageal reflux.

4. Silent reflux.

Lactose Intolerance

Temporary lactose intolerance (LI) in infants can cause gastrointestinal symptoms such as diarrhoea, cramping and bloating, and symptoms can be confused with delayed cows’ milk allergy (CMA). To assist healthcare professionals in differentiating between LI and CMA, we have developed a plethora of different research-based materials based on our knowledge and expertise in this area.

1. Understanding lactose intolerance.

There are three main types of lactose intolerance: Congenital lactose intolerance, Primary lactose intolerance, and Secondary lactose intolerance. For more detailed information, as well as references, please read the full article. .

2. Understanding the difference between Lactose Intolerance and Cows’ Milk Allergy.

Due to several similarities in their symptoms, lactose intolerance is often confused with cows’ milk allergy (CMA). This article explains the key differences between these two conditions to help you recognise one from the other.

Cows’ Milk Allergy

The prevalence of allergy is increasing, as is our collective understanding about its impact on long term health. In the case of cows’ milk allergy (CMA) the immune system overreacts to one or more “proteins” contained in cows’ milk³. CMA is the most common food allergy in early childhood and it affects 2–5% of infants⁴. The symptoms are incredibly broad and can range from issues like diarrhoea, to issues like wheezing and eczema; it can be distressing for both the infant and their families.

With over 40 years’ experience of innovation in cows’ milk allergy, we are pioneering solutions for the dietary management of cows’ milk allergy in infants and young children.

To help healthcare professionals support mums with this dietary management, we have created a bank of free resources for them to use in their daily practices. This includes a range of free printed resources, which includes a Cows’ Milk Allergy Recipe Booklet with over 20 weaning recipes. There is a host of other invaluable, evidence-based, resources for healthcare professionals to lean on to help them support mums during the first 1,000 days:

Baby Symptom Checker

The Baby Symptom Checker takes ten minutes and offers practical tips and a handy symptom summary for mothers to show their Pharmacist, Health Visitor or GP.

Our baby symptom checker is designed to help parents have more informed conversations with their healthcare professional around a potential problem, which may help lead to a faster diagnosis.

Dalton size debate in extensively hydrolysed formulas.

In this downloadable and easily shareable PDF, leading Paediatric Allergy Dietitian, Dr Rosan Meyer, discusses the processes and the science behind extensively hydrolysed formulas in order to investigate the relevance of Dalton Size.

What are prebiotics and why are they important?

Healthcare professionals need as much information as possible on the implications of prebiotics on infant health, and this important and thorough review focuses on the role of prebiotics in the prevention of allergic disease.

Cows’ milk allergy — a case study

To parents Sian and Alex, their baby boy Finley was healthy and developing well on the breast. Nothing could have prepared them for the difficulties they would experience when they tried to wean him.

Cows’ Milk Allergy: myth v reality

There is often confusion about the diagnosis and management of cows’ milk allergy (CMA). In this feature, renowned specialist paediatric allergy dietitian, Dr Carina Venter, looks at ten common misconceptions and replaces myths with facts.

Cows’ milk protein allergy: NICE — a practical summary

A useful and practical summary of the National Institute for Health and Care Excellence (NICE) guidelines for the diagnosis and assessment of food allergy in children and young people in primary care and community settings.


IMPORTANT NOTICE: Breastfeeding is best for babies. Infant formula is suitable from birth when babies are not breastfed. Follow-on milk is only for babies over 6 months, as part of a mixed diet and should not be used as a breastmilk substitute before 6 months. We advise that all formula milks including the decision to start weaning should be made on the advice of a doctor, midwife, health visitor, public health nurse, dietitian, pharmacist or other professional responsible for maternal and child care. Foods for special medical purposes should only be used under medical supervision. May be suitable for use as the sole source of nutrition for infants from birth, and/or as part of a balanced diet from 6–12 months. Refer to label for details.